Health and wellbeing programme summary 2014-19 Introduction

The Office of Rail Regulation (ORR) is the independent economic and health and safety regulator for the rail industry. We work to enforce health and safety legislation and ensure best practice across the industry on health and safety.

Our vision is for a rail industry that consistently achieves excellence in occupational health. To achieve this we will;

- encourage industry leadership and engagement on health
- ensure legal compliance on occupational health and welfare
- promote awareness of health issues
- encourage a culture of excellence in the management of health and wellbeing.

Why occupational health matters

The railway industry employs more than 150,000 people on mainline and light rail, so the health and wellbeing of its workforce is crucial to our industry’s success. Effective health management benefits everyone – employees and their families, the organisations they work for and ultimately drives improvements for customers and passengers. A recent RSSB report estimates that 1.06 million working days are lost due to sick absence across the industry each year. Progress in this area can really make a difference – even a reduction of 0.4% could deliver savings in sick absence costs of £32m. ¹

Over the last few years, there has been increasing focus on health and wellbeing policy and practices as evidenced in the case studies included on our web page and this booklet. However there is still some way to go before the rail industry consistently achieves excellence in managing health issues. In our five year plan for the railways from April 2014-2019, occupational health measures have been included. We will monitor Network Rail’s progress to deliver its health and wellbeing strategy, how they put in place measures to prevent ill health and achieve savings of at least £50m.

The biggest impact on better management of health and wellbeing is on individuals themselves – they have healthier and safer places to work, are less likely to become ill or injured and are able to return to the workplace quicker following sick absence.

¹ This figure is from the cost of impaired health research carried out on behalf of RSSB into the costs of impaired health across the network. Occupational Health 5 year plan – what we expect from industry

In April 2014, we published our 2nd occupational health programme setting out how we will work with industry to ensure continued improvement over the next five years. This sets four priorities for railway companies to strive for when improving the health of its workers;

- **excellence** in health risk management – including implementing health strategies and action plans eg exposure monitoring and health surveillance

- greater **engagement** with employees and others – for example signing up to the Department of Health Responsibility Pledge(^2) and using technical specialists such as ergonomists on improving rolling stock design, to minimise risks to employees health and wellbeing

- better **efficiency** and reduced costs from people suffering from work related ill health – including developing more consistent metrics to measure levels of absence and the reasons for this to allow improved understanding of these across industry

- **enabling** improvements in competency, information, co-ordination and control.

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**Occupational Health Physiotherapy Transport for London**

Many train operators and organisations have seen the benefits of providing physiotherapy to people who sustain an injury at work or have long term musculoskeletal problems.

In 2000 London Underground introduced a physiotherapist to their Occupational Health Team to trial a physiotherapy assessment and treatment service for workers with low back pain. This showed an improvement in the return to work rate of 12 days, so they adopted physiotherapy across Transport for London. The service includes health fairs, assessment, treatment, pain education classes, a back fitness group and workplace visits. Return to work advice and occupational rehabilitation is integrated into the service.

A study of the 234 patients referred to this service in 2006 showed that 96% returned to work within 1 month, 99.6% by 3 months and that only 15% had any reoccurrence in sickness absence the following year. Early referral to the service (within six weeks) halves the time spent off work. The return on investment associated with reduced sickness absence is estimated to be £10.30 for every £1 spent and musculoskeletal medical retirements have reduced by 74% in the 10 years since the service began.

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(^2) DoH Responsibility Pledge can be found at [www.responsibilitydeal.dh.gov.uk/health-at-work-pledges/](http://www.responsibilitydeal.dh.gov.uk/health-at-work-pledges/)

### What we will do

| Excellence | • encourage train operators to develop and implement a health policy to address key health risks, eg musculoskeletal disorders and stress\
• carry out targeted inspections on key health risks, e.g. Hand Arm Vibration Syndrome (HAVS), exposure to dust fumes etc\
• encourage industry to work with others including the trade unions to benefit their business and health of the workforce\
• where legislation covers aspects of health, welfare and wellbeing we will ensure that organisations comply with this, and encourage best employment practice where it does not\
• work in conjunction with other bodies including the Health and Safety Executive (HSE), RSSB, the Health Policy Group and Rail Delivery Group to deliver and encourage best practice | | Engagement | • distribute a free quarterly rail industry health newsletter and share helpful guidance and best practice case studies on our website\
• support the RSSB Industry Roadmap initiatives\
• provide input to collaborative industry working groups e.g. ballast dust\
• collaborate with trade unions on improving engagement on health. | | Efficiency | • develop case studies demonstrating return on investment\
• participate in the RSSB Roadmap economics activities\
• develop financial cost models and indicators to measure efficiency savings\
• encourage duty-holders to adopt good practice by early intervention e.g. physiotherapy or improved practices in managing stress. | | Enabling | • publish RIDDOR data on health on our National Rail Trend data portal\
• publish an updated position paper on the 2010-14 Health programme\
• develop information on passenger health concerns\
• participate in the EU-OSHA European Week for Safety & Health at Work\
• benchmark industry progress. | We will monitor industry progress and track the success of our own programme. Specific measures are set out in our Occupational Health five year programme ‘Making it Happen’ on our website.

**More help and information**

There is more detail and further case studies on the ORR website, where you can also sign up for our quarterly industry updates.

[www.orr.gov.uk/what-and-how-we-regulate/health-and-safety/occupational-health](http://www.orr.gov.uk/what-and-how-we-regulate/health-and-safety/occupational-health)

You can also contact us at; [claire.dickinson@orr.gsi.gov.uk](mailto:claire.dickinson@orr.gsi.gov.uk)